<html>
<body><br/><br/>
<center><font size="6" color="blue"><b>COMMENTS</b></font></center>
<br/><br/>
<table border="3" bordercolor="black" align="center">
<tr>
<td><b>Name</b></td>
<td><input type="text"></td>
</tr>
<tr>
<td><b>Phone No.</b></td>
<td><input type="text"></td>
</tr>
<tr>
<td><b>e-mail id</b></td>
<td><input type="text">
</tr>
<tr>
<td><b>Department</b></td>
<td><select><option>Software</option>
</select>
</tr>
<tr>
<td><b>Comments</b></td>
<td><textarea rows="5" cols="20"></textarea></td>
</tr>
</table>
</body>
</html>